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Massage Flashcards

1
Q

Massage Precautions

A 
Hematomas
non-union fractures
herniated discs
debilitated patients
malignancies
conditions with collagen weakening
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2
Q

Massage Contraindications

A 
When increased circulation is not desired
severe disease / distress
contagious skin disease
over foreign bodies or sharp bony prominences
Acute Conditions
Areas of decreased sensation
over recent surgery
systemic edema
areas of active bone growth
tuberculosis
pregnancy
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3
Q

Massage Indications

A 
Pain
Edema
Trigger Point
Spasm
Contracted Tissue
inefficiencies of circulation
Specific, or general relaxation
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4
Q

What are the general principles regarding strokes?

A 
work broad & light to specific & deep.
 mold hands to pt body
deep pressure: distal to proximal
address entire length of muscle
minimize interruptions
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5
Q

What are the Principles regarding massage?

A

Direction (linear, cross-fiber, distal, proximal)
Duration (take adequate time time to achieve goal)
Pressure (varies based on intent, body region, pathology, and patient tolerance)
Rate & Rhythm (should be purposeful and consistent)

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6
Q

Basic Massage Strokes

learned in class

A

Effleurage, petrissage & compression, friction, jostling, tapotement, trigger point technique, myofascial release

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7
Q

Effleurage

A

superficial - relaxing, calming effect
deep - reflex and mechanical effects

Used for information gathering. calming / focusing. warming of superficial tissues.

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8
Q

Petrissage

A

Intermittent kneading (may be unilateral, bilateral, or digital)

Increases circulation
softens and lengthens tissue

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9
Q

Friction

A

sustained pressure with movement

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10
Q

Jostling

A

rhythmic shaking of tissue or limb
decreases muscle guarding
relaxing

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11
Q

Tapotement

A

hacking, beating, gorilla punching, chopping, slapping

excitatory

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12
Q

What are the considerations for draping?

A

only expose area that you will be treating. parts not treated should be covered by a towel or a sheet

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13
Q

What is a trigger point?

A

focus of hypersensistivity in a tissue, that, when compressed, is locally tender and, if sufficiently hypersensitive, give rise to referred pain and tenderness, and sometimes to referred autonomic phenomena and distortion of proprioception

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14
Q

What are the characteristics of triggerpoints?

A

consistent referred pain patter upon compression.
Local twitch response elicited by palpation
possible restriction in ROM
muscle weakness with no appreciable atrophy possible autonomic phenomena including vasomotor and pliomotor responses

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15
Q

Active Trigger Points

A

always tender, produce referred pain
associated muscle may be weak and present with decreased motion/flexibility
when palpated, present with localized twitch response

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16
Q

Latent Trigger Points

A

painful only when palpated,

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17
Q

TrP Causes

A

fractures, sprains, dislocations, muscle impact injuries, stress from excessive, or unusual exercise, articular dysfunction, overload on the muscle from prolonged stationary posture or prolonged immobilization in a shortened position
nerve compression

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18
Q

What are the indications of a JOBST Pump?

A

Edema

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19
Q

What are the contraindications of a JOBST pump?

A

Thrombophlebitis, cellulitis, severe congestive heart failure

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20
Q

What is the treatment time of a JOBST pump?

A

10min-4 hours 1-2 times per day

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21
Q

What is the Duty Booty of the JOBST pump?

A

45 Sec on / 15 sec off to 3min on / 1 min off

22
Q

What should the pressures never exceed (in arm, leg, and overall)

A

Should never exceed 90-120mmHG

Arm - 50mmHG
Leg 60-70mmHG

23
Q

Indications for Cyriax (friction massage)

A

Promote healing of connective and contractile tissue
To retain or regain mobility
Pain Modulation

24
Q

Contraindications for Cyriax (friction massage)

A

Acute inflammation
Hematoma
Conditions that increase bleeding (hemophilia, anti-coagulants, steroids)
Debilitated/open skin

25
What are the general effects of massage CV system
Circulation Dilation of vessels via local reflex increase SV by venous return decrease DVT by decrease in viscosity & hematocrit edema - increases lymph flow via mechanical pressure
26
What are the general effects of massage on connective tissue
Decreases pain and improves tissue mobility
27
What are the general effects of massage on muscle tissue and nervous system?
in muscle tissue, it decreases spasm, and decreases muscle hypertension. In the nervous system, it decreases pain via gateway theory of pain and also an increase in opiate production.
28
List the types of swelling in the body and describe the physiological effects behind why they occur.
Joint Swelling cause by pressure of blood and joint fluid in a joint as a result of tearing of tissues an blood vessels or synovial irritation Has appearance and feel of a water balloon. Interstitial Swelling caused by an increase of osmotic pressure in tissues which attracts water and creates swelling has the appearance of “silly putty” when involved tissue is pressed Cell Swelling cells near death and unable to control the cell membrance can attract water and swell Congestive heart failure heart that is so stretched, it does not produce a large contractile force, ~10% left in heart → when it fills again, decreased CO due to more stretch from remaining blood left in the heart. easiest sign → swelling in all extremities. Venous insufficiency Kidney Failure can’t filter out waste, so excess salt is left in the blood, which creates a gradiant, and swelling occurs.
29
What is the purpose of friction massage?
to mobilize adherent tissue reduce/mobilize trigger points increase local circulation decrease pain
30
Types of friction massage (4)
cyriax, linear/parallel, circular friction, and cross-fiber friction
31
What is cross fiber friction massage?
deep friction applied perpendicular to the fibers
32
What is parallel friction massage?
deep friction applied in the same direction of the fibers
33
What is circular friction massage?
repeated circular motion, distal to proximal consideration
34
What is Deep transverse friction massage? (DTFM) aka Cyriax
Technique used to reduce adhesions and make scar tissue more mobile in sub-acute and chronic inflammatory stages by realigning normal soft tissue fibers
35
What are the effects of DTFM? (4)
mechanical - mobilization of damaged tissue over a small area and elongation of fibers Physiological - localized edema Histological - prevents or slows scar formation and stimulates collagen orientation along lines of stress Neurological - pain inhibition via stimulation of mechanoreceptors `
36
What should you do before and after using a JOBST pump?
perform volumetric or circumferential measurements to determine efficiency.
37
What are the factors that can cause edema?
1. high capillary pressure (blood pressure or blood clots) 2. low blood plasma (starvation, alcoholism, hypothyroidism) 3. lymphatic blockage (post mastectomy, elephantitis) 4. increased capillary porosity releases electrolytes and proteins (burns, allergic reactions).
38
Pitting Edema
the maintenance of a depression for 5-30 seconds following physical pressure on an area. caused by fluid being expressed from the interstitial area by the pressure and slowly returning as the pressure is removed.
39
Non-pitting Edema
swollen tissue which the fluids cannot be displaced from. may be due to swelling of individual cells (secondary to trauma or poor nutrition) or due to coagulation of tissue or capture of fluids by a gel-like substance which prevents the fluids from being expressed.
40
Lymphedema (define primary and secondary)
1. Primary - congenital blockage of lymph channels. Edema caused by obstruction of the lymph channels. could be to the extent that they can't drain 2. Secondary: inflammation - pressure of swelling blocks fluids Trauma - causing inflammation (scar tissue can cause blockage) Neoplasm - growth that is space occupying (prevents /blocks fluid movement) Irradiation - increase dose of x-ray can cause damage of tissue
41
Treatment of Edema
Elevation, muscular contraction, compression, elastic compression, massage, intermittent compression (JOBST)
42
What are the three effects of Cyriax Massage?
1. Traumatic Hyperemia 2. mobilize adherent tissues 3. Stimulate mechanoreceptors
43
What are the key points of Cyriax Friction Massage?
1. Friction is applied to an exact location 2. No movement between the fingers and skin 3. Friction is applied in transverse direction 4. Friction must have adequate amplitude to move completely over structure 5. Friction must be applied at a depth sufficient enough to reach the target structure
44
What are the three function of the lymphatic system?
1. Remove excess fluids from tiissue 2. Absorption of fatty acids anf subsequent transport of fat to the circulatory system 3. production of immune cells
45
Cyriax Massage position for Muscles
supported in a position of relaxation or reduced muscle tone
46
Cyriax Massage position for tendons
must be at end ROM
47
Cyriax Massage positions for ligaments
taut, as far as the ROM allows
48
Treatment protocol cyriax
initial treatment is 5-6min. 1st 1-2 min pt may feel pain, but will subside. once it does, increase pressure, check every 1-2min and increase.
49
Trigger point pressure release
gentle digital pressure, aim to reduce ischemic effect to the injured tissue. One finger palpating the TrP while the muscle is passively lengthened to the point of resistance. At tissue resistance pressure on TrP is slowly increase
50
Digital Compression
should be applied to one point for a prolonged period and pressure released with resolution of pain.

Modalities (15 decks)

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